1 Mental Health Care Institute GGZ Centraal, Amersfoort, the Netherlands.
2 GGZ inGeest/Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Can J Psychiatry. 2018 Feb;63(2):85-93. doi: 10.1177/0706743717711170. Epub 2017 May 16.
Obsessive-compulsive symptoms (OCS) co-occur frequently with anxiety and depressive disorders, but the nature of their relationship and their impact on severity of anxiety and depressive disorders is poorly understood. In a large sample of patients with anxiety and depressive disorders, we assessed the frequency of OCS, defined as a Young Adult Self-Report Scale-obsessive-compulsive symptoms score >7. The associations between OCS and severity of anxiety and/or depressive disorders were examined, and it was investigated whether OCS predict onset, relapse, and persistence of anxiety and depressive disorders.
Data were obtained from the third (at 2-year follow-up) and fourth wave (at 4-year follow-up) of data collection in the Netherlands Study of Anxiety and Depression cohort, including 469 healthy controls, 909 participants with a remitted disorder, and 747 participants with a current anxiety and/or depressive disorder.
OCS were present in 23.6% of the total sample, most notably in those with current combined anxiety and depressive disorders. In patients with a current disorder, OCS were associated with severity of this disorder. Moreover, OCS predicted (1) first onset of anxiety and/or depressive disorders in healthy controls (odds ratio [OR], 5.79; 95% confidence interval [CI], 1.15 to 29.14), (2) relapse in those with remitted anxiety and/or depressive disorders (OR, 2.31; 95% CI, 1.55 to 3.46), and (3) persistence in patients with the combination of current anxiety and depressive disorders (OR, 4.42; 95% CI, 2.54 to 7.70) within the 2-year follow-up period Conclusions: OCS are closely related to both the presence and severity of anxiety and depressive disorders and affect their course trajectories. Hence, OCS might be regarded as a course specifier signaling unfavorable outcomes. This specifier may be useful in clinical care to adapt and intensify treatment in individual patients.
强迫症症状（OCS）常与焦虑和抑郁障碍共病，但它们之间的关系及其对焦虑和抑郁障碍严重程度的影响仍不清楚。在一个患有焦虑和抑郁障碍的大样本患者中，我们评估了 OCS 的频率，定义为青年自评量表-强迫症状评分>7。检查了 OCS 与焦虑和/或抑郁障碍严重程度之间的关联，并研究了 OCS 是否预测焦虑和抑郁障碍的发作、复发和持续。
数据来自荷兰焦虑和抑郁队列研究的第三（2 年随访）和第四波（4 年随访）的数据收集，包括 469 名健康对照者、909 名缓解障碍者和 747 名当前患有焦虑和/或抑郁障碍者。
OCS 存在于总样本的 23.6%，尤其是在当前患有混合性焦虑和抑郁障碍的患者中。在当前患有疾病的患者中，OCS 与该疾病的严重程度有关。此外，OCS 预测（1）健康对照者中焦虑和/或抑郁障碍的首次发作（优势比[OR]，5.79；95%置信区间[CI]，1.15 至 29.14），（2）缓解的焦虑和/或抑郁障碍患者的复发（OR，2.31；95%CI，1.55 至 3.46），以及（3）当前焦虑和抑郁障碍合并患者的持续性（OR，4.42；95%CI，2.54 至 7.70）在 2 年随访期间。
OCS 与焦虑和抑郁障碍的存在和严重程度密切相关，并影响其病程轨迹。因此，OCS 可能被视为预示不良结局的病程特征。在临床护理中，该特征可能有助于针对个体患者调整和强化治疗。
